The Means of Reproduction: Sex, Power, and the Future of the World (4 page)

In 2005, the UN Human Rights Committee decided its first abortion case, which dealt with a seventeen-year-old Peruvian girl who’d been forced to carry an anencephalic fetus—one missing most of its forebrain—to term, despite the fact that it had no chance of surviving more than a few days outside the womb. The committee ruled that Peru had “an obligation to take steps to ensure that similar violations do not occur in the future.” The following year saw the resolution of a case before the Washington, D.C.-based Inter-American Commission on Human Rights involving a thirteen-year-old Mexican rape victim, Paulina Ramírez, who was prevented from having an abortion by public officials. The government of Mexico settled, agreeing to pay Ramírez, by then a nineteen-year-old single mother, forty thousand dollars plus a stipend for her son’s high school education. It also pledged to force local authorities to comply with laws allowing abortion in cases of rape.

A couple of months later, Colombia’s Supreme Court struck down that country’s total abortion ban, citing both its own constitution and international law. The court ruled:

Various international treaties form the basis for the recognition and the protection of the reproductive rights of women, which derive from the protection of other fundamental rights such as the right to life, health, equality, the right to be free from discrimination, the right to liberty, bodily integrity and the right to be free from violence.... Sexual and reproductive rights of women have been finally recognized as human rights. As such, they have entered the realm of constitutional law, which is the fundamental ground of all democratic states.

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uttressing local conservatives, the American right has exerted powerful pressure in the other direction. Reinstituting a Republican policy first seen under Reagan, the George W. Bush administration famously cut off American family planning aid to groups that performed abortions, counseled pregnant women about where they could get abortions, or lobbied for the liberalization of abortion law.

Other Republican politicians got even more intimately involved in the abortion debate abroad. In 2004, when Uruguay moved to make abortion legal during the first trimester of pregnancy, the office of New Jersey congressman Chris Smith faxed a letter, cosigned by five other Republican representatives, to every member of that country’s Senate, urging them to defeat the bill, saying it would “legalize the violent murder of unborn children and the exploitation of women through abortion up to the 12th week of pregnancy.” (It lost by four votes.) That same year Smith attended a meeting of Latin American and Caribbean countries in Puerto Rico, where he urged several heads of state not to affirm international agreements on women’s rights. “These documents contain direct attacks on the right to life, family rights and national sovereignty,” the congressman wrote in a letter to the president and first lady of Guatemala.

Nicaragua’s abortion ban was “a show of force by conservative forces in Latin America,” said Luisa Cabal, director of the international legal program at the Center for Reproductive Rights and one of Ramírez’s attorneys. “What we see now is a more concerted effort by antichoice groups.... My concern is that the antichoice groups will start pushing for reform in other countries.” Cabal worries that similar legal changes could be afoot in the Dominican Republic and Panama, among other places.

The globalized conflicts over women’s rights and religious authority that are playing out across the developing world have led to political realignments that complicate the simpler left/right divides of the cold war years. These days religious conservatives adopt the language of radical anticolonialism to attack the liberalism of the developed world. Just as in the United States, social progressives, especially feminists, are smeared as decadent elites, and reproductive rights are excoriated as an assault on the soul of nations. Denouncing groups that promote such rights, Dr. Rafael Cabrera, a Nicaraguan ob-gyn who emerged as a leader in the campaign against therapeutic abortion, called them “foreigners who do not represent Nicaraguans, feminist movements that promote lesbianism and organizations that promote sexual licentiousness and homosexuality.”
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During the cold war the jagged divide between the economic left and right vastly overshadowed conflicts between cultural liberalism and fundamentalism. Indeed, ardent Catholics and Protestants were often on opposing sides. While evangelical conservatives in the United States raised money for the Nicaraguan Contras and for Efraín Ríos Montt, Guatemala’s extravagantly zealous Pentecostal dictator, much of Latin America’s Catholic Church, influenced by liberation theology, was an ally of revolution and a powerful force for social justice. Liberation theologians weren’t liberal on sexual issues, but they focused more on repression and systematic injustice than on individual sexual sin. This brought out a kind of crude anticlericalism in their opponents. In El Salvador, militant reactionaries circulated leaflets saying “Be a patriot—kill a priest.” A few years later a right-wing death squad did just that, by assassinating San Salvador’s archbishop, Oscar Romero, as he celebrated mass at a small chapel in the capital. Roberto D’Aubuisson, a man with ties to American right-wing stalwarts like the late senator Jesse Helms, ordered the killing.
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Under Pope John Paul II the Vatican was deeply critical of liberation theology, and it moved to elevate more conservative clerics. (The head of the Congregation for the Doctrine of the Faith, Cardinal Joseph Ratzinger—now Pope Benedict XVI—was an especial opponent of the liberation theologians.) In the mid-1990s, Fernando Sáenz Lacalle, a member of the ultraconservative Catholic group Opus Dei and an ally of ARENA, the right-wing party originally founded by D’Aubuisson, became San Salvador’s new archbishop.
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The conservative shift in the church heralded a new focus on sex and motherhood. Abortion was already severely restricted in El Salvador, but until the late 1990s there were legal exceptions for rape, severe fetal malformation, or danger to a mother’s life. In the early 1990s, though, conservatives began agitating for a complete prohibition. Then, in 1995, the FMLN—the revolutionary movement turned left-wing political party—proposed a bill liberalizing the country’s abortion law, turning up the heat on the issue even further. Two years later, when ARENA introduced a bill banning abortion totally, the archbishop, who compared legal abortion to Nazi genocide, backed it enthusiastically. Thousands of students from Catholic schools were organized to demonstrate on behalf of the law, and the country’s leading pro-life group gathered a half million signatures supporting it. In an argument that would reappear in Nicaragua nearly a decade later, Julia Regina de Cardenal, head of the Yes to Life Foundation, argued that medical advances had made therapeutic abortion unnecessary. In 1998, all exemptions to the abortion ban were struck from the penal code, and the next year, the country’s constitution was amended to decree that life be protected from the moment of conception.

Between 2000 and 2003, 283 criminal investigations were initiated against women suspected of aborting.
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Abortion remains common in El Salvador: Though exact figures are impossible to obtain, the World Health Organization estimates that there were thirty-four thousand illegal abortions in 2003.
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Women with complications from such abortions take an enormous risk if they seek medical help, because, as the Center for Reproductive Rights has found, half of the women prosecuted for abortion were reported by their health care providers. Employees at public hospitals were more likely to report their patients than those at private hospitals, often because they felt legally bound to do so.
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octors may come under similar pressure in Nicaragua. Harley Morales, a young ob-gyn at Berta Calderon, a public women’s hospital in Managua, said that officials have told doctors there that police would soon be stationed in the emergency room to report women suspected of seeking help for complications from illegal abortions. Such complications are common, though they’ve become less so due to the spread of misoprostol, an ulcer medicine that can induce abortion at high doses. Though still risky and illegal, such abortions are safer than those performed manually.

“When I was in my sixth year as an intern, this room was filled with patients with complications from abortions,” said Morales. We were sitting in a small, pink operating room with flimsy teal curtains. Before misoprostol, he said, women were more likely to use methods that were “
muy artesanal,
” or homemade—umbrella spokes, wood sticks, coat hangers. (“We could have had a museum of the things we took out of women’s bodies,” Ligia Altamirano told me.) The spread of the drug has cut down on such practices, and when women using it suffer complications, they can plausibly report them as miscarriages. Of the approximately ten women a day who come to Berta Calderon with miscarriages, Morales estimates that more than half are self-induced.

Even with misoprostol available, horrifying cases persist. The day I spoke with him Morales had a patient he’d first seen three weeks earlier, when she came in threatening to commit suicide because, already poor and raising one small child, she found herself pregnant again. The hospital sent her home. When she returned, she’d had an illegal abortion and was in septic shock, with a severe infection in her uterus. She had to have a hysterectomy and was in intensive care for a week. She was twenty-one.

Luckily—if “luck” isn’t too perverse a word—the hospital didn’t have to report her to the authorities. If Nicaragua follows El Salvador, though, that could change.

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n the waiting room of Dr. Cabrera’s Managua office hangs a framed group photo taken at the Vatican, of him and a few others with Pope John Paul II. There’s also a certificate of commendation from the pope, along with a huge fetal gestational chart. A father of six, Cabrera is stout, and has a sagging owlish face, thin hair, and round glasses. Earlier, when I had mentioned his name to Altamirano, she’d shuddered and crossed herself, but the man sitting before me doesn’t look at all harsh or frightening. Rather, he appears both kindly and a little melancholy, and I imagine he would have a comforting bedside manner. When it comes to abortion, though, he is rigid and uncompromising. Asked about Jazmina Bojorge, he said only that her death was an “obstetric accident.” Nor is he apologetic about the prospect of women who’ve had abortions being sent to prison. “If a person deliberately produces the death of another human being, the law says what should happen to them,” he said. “The law is hard, but it is the law.” (Of course, he was a driving force in crafting that law.)

Cabrera is the president of the Asociación Nicaragüense por la Vida, or Anprovida, the country’s leading antiabortion group and an affiliate of the Virginia-based Human Life International. He gave me a Spanish-language flier HLI had produced about the International Planned Parenthood Federation titled “Mortal deceit: The IPPF’s Attack on Children, Families and National sovereignty.” As he sees it, a network of promiscuity-promoting foreigners has been subverting Nicaragua’s values for over twenty years, and the abortion ban is an attempt to beat them back.

“Since 1984, NGOs have started to organize here, backed by foreign agencies—IPPF, Ipas, Pathfinder, Marie Stopes, and others,” he said. “They’ve started programs for women that include contraception, and many of them practice abortion.” These groups, he said, manipulated the law by getting doctors working for them to sign off on abortions for women who could have carried their pregnancies to term. They tried to expand the term “therapeutic abortion” to include abortions in cases of rape, incest, fetal malformation, and poverty. By the 1990s, he said, they’d created clinics that practice abortion as a “business.”

“All these abuses came to a peak in the case of the girl Rosa,” he said.

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he girl he’s talking about, known throughout the country only by her pseudonymous first name, was the child of young Nicaraguan migrants working as coffee pickers in Costa Rica. Also called Rosita, the diminutive of Rosa, she was nearing her ninth birthday when she became pregnant. Her family claimed she’d been raped by a young man who lived nearby.

Rosa’s story became the focus of a media circus in Nicaragua, and it was an international feminist cause célèbre. Indeed, one of the few things that both sides in Nicaragua’s abortion debate agree upon is the role of the Rosa case in ratcheting up the conflict. “This case demystified the concept of abortion,” said Violeta Delgado Sarmiento, a feminist who was deeply involved in the controversy. “Before the Rosita case even the women’s movement didn’t talk about abortion. But during that case, the media started an interesting debate, where they talked more deeply about abortion and about the conditions under which women have abortions.”

It appears to an outsider like a strange case to galvanize pro-life forces, because in many ways the girl seemed like a poster child for legal abortion. But fury over Rosa lingers, a sign both of the uncompromising absolutism of Nicaragua’s antiabortion lobby and of the mistakes the women’s movement made in its search for a story that would capture the world’s attention.

Like Nicaragua, Costa Rica has very strict antiabortion laws, and abortion was never presented as an option to either Rosa or her mother, María Esquivel. Instead, Esquivel was told that Rosa would have to stay in the hospital until she delivered, and she was instructed not to tell Rosa’s stepfather, Francisco Fletes. Some health officials believed Fletes had raped his stepdaughter, but the family insisted otherwise, and the neighbor Rosa identified as her rapist was eventually arrested, though he was never convicted. The girl didn’t understand what was happening to her and asked her mother when she would be “cured.”
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